The axons of autonomic neurons in the cranial nerve nuclei and sacral spinal segments usually produce effects opposite to those produced by the axons of neurons in the thoracolumbar intermediolateral…
ARSENIC Arsenic has a ubiquitous distribution in the environment, particularly as an impurity in copper ores. Although it is a means of notorious surreptitious homicide, the presence of excessive levels…
ALCOHOL The prevalence of neuropathy in alcohol use is uncertain, but has been estimated to exist in approximately 50% of alcoholics. Incidence of neuropathy in alcoholics correlates with age of…
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) shares many similarities with GBS but also important differences. For example, the autoimmune attack of CIDP is chronic, not self-limiting as with GBS. Furthermore, CIDP…
SJÖGREN SYNDROME Sjögren syndrome (SS) is a systemic autoimmune disease that primarily affects middle-aged women. The criteria for diagnosis include sicca symptoms (dry eyes, dry mouth), objective evidence of keratoconjunctivitis,…
Vasculitic neuropathies usually manifest with asymmetric nerve involvement, in a stepwise fashion often described as mononeuritis multiplex. They are often painful, in addition to clinically manifesting with signs of focal…
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IgM MGUS NEUROPATHY Although most patients who present with chronic distal sensory or sensorimotor symptoms and signs have an axonal polyneuropathy unrelated to a paraprotein, rarely, patients with distal clinical…
The diagnosis of CIDP can be challenging. Patients generally have both proximal and distal weakness on examination. Deep tendon reflexes are markedly reduced or absent. Distal sensory loss is often…
CLINICAL MANIFESTATIONS Diabetic polyneuropathy (DPN) is one of the most common neuropathies seen in clinical practices (see Plate 6-21). It is generally length dependent, with prominent sensory symptoms, and can…
